It’s not a new phenomenon for hospitals and health systems to want to improve the quality of their healthcare services. Efforts to create standards for measuring the quality of care or procedures in our country go back to the 1800s. As healthcare quality measurement continued to evolve throughout the 1900s and into this century, hospitals developed their own benchmarks to maintain and improve the quality of patient care while also working to adhere to new national frameworks.
Achieving better quality scores has become a non-stop job for the industry for reasons beyond providing excellent healthcare, such as attracting more patients and the best available practitioners, increasing reimbursements, and establishing prestige that leads to opportunities for change and growth. But just because a hospital is aggressive in its quality improvement (QI) initiatives, there’s no guarantee that it will enjoy better quality scores. Hospitals get stuck due to the fundamental way in which their QI programs are designed and operated. It’s time to improve the quality of quality improvement!
Who’s keeping score on healthcare quality?
Part of the US Department of Health and Human Services (HHS), the Agency for Healthcare Research and Quality (AHRQ) is the top federal agency in charge of making the country’s healthcare system safer and of higher quality. It provides healthcare professionals with quality improvement measurement tools and information to drive care enhancements and better-informed consumer decisions. The AHRQ also produces an annual National Healthcare Quality and Disparities Report. Mandated by Congress and based on 250+ quality and disparity measures, the report describes quality focused on six priorities:
- Patient safety
- Person-centered care
- Care coordination
- Effective treatment
- Healthy living
- Care affordability.
The 2019 report, released in December 2020, found that slightly more than half of healthcare access measures showed improvement, while the remaining ones stayed the same or worsened. And while the overall quality of healthcare improved from 2000 through 2018, not all focus areas progressed at the same rate. Healthcare disparities continued and even intensified for uninsured and poor populations; the report revealed variations due to race, ethnic group, and location.
There’s also the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), which has established national guidelines to collect and report feedback on care from discharged patients to help compare quality consistently for all hospitals. The HCAHPS Survey/CAHPS® Hospital Survey/Hospital CAHPS includes 29 questions, 19 of them related to vital facets of the hospital experience. It's part of the Centers for Medicare & Medicaid Services (CMS) hospital quality initiative.
To focus on providing urgent patient care, the CMS gave clinicians some relief last year due to their unprecedented COVID-19 workloads. It granted exceptions from some reporting obligations as well as extensions to those who submit data to Medicare quality reporting programs. In fact, CMS did not count data for 11 hospital performance or payment programs for the entire first half of 2020. The agency collects data on quality measured in numerous ways, including insurance claims, surveys, chart abstractions, and registries.
Streamlining the QI process makes projects more effective
Given the growing amount of quality reporting required of hospitals, it’s imperative that QI projects be constantly deployed and completed. But do the results of these projects actually contribute to better quality scores? It depends on every aspect of the project, from identifying and correctly stating the problem to reaching and disseminating an actionable conclusion.
Some hospitals have well-organized QI programs; others, not so much. Here are some questions hospitals should ask about the state of their quality improvement efforts:
- Is there a simple, centralized way for both hospital executives and project leaders to see all QI projects — past, current, and proposed — in real-time?
- Are there standardized workflow templates for QI teams to easily access and customize?
- Can QI team members effectively collaborate on projects and track their evolution?
- Does the literature available for search offer full-text articles most relevant to the identified QI problem?
- Is critical appraisal resulting in valuable, substantiated recommendations?
- Are QI projects prioritized and completed on time, with findings rapidly disseminated?
If a hospital or health system cannot respond affirmatively to all of these questions, it’s time to identify ways to enhance its QI program. Take a look at the available technology; it can truly elevate quality improvement to the next level, contributing as a team member. When QI projects consistently succeed in raising health quality scores, everybody wins!
Learn how Ovid Synthesis' workflow solution can streamline your quality improvement projects and impact scores.